Pulmonary Arteriovenous Malformations: Diagnosis and Management
A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Vascular Medicine".
Deadline for manuscript submissions: closed (31 January 2022) | Viewed by 4915
Special Issue Editor
Interests: radiology- interventional; embolization; pulmonary arteriovenous malformations- embolization; Uterine fibroid- embolization and MR; peripheral arterial interventions- ballons and stents; thorax radiology- diagnostic and interventional; osteochondrodysplasias- diagnostics and epidemiology
Special Issue Information
Dear Colleagues,
Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant inherited vascular disease in which patients may develop mucocutaneous telangiectatic lesions and visceral arteriovenous malformation. Especially pulmonary arteriovenous malformations (PAVM) may have severe consequences for the patients, if untreated. PAVM are congenital vascular anomalies of the lung in which abnormally dilated vessels provide a direct capillary-free communication between the pulmonary and systemic circulations with three main clinical consequences: (1 pulmonary arterial blood passing through these right-to-left shunts cannot be oxygenated, which leads to arterial hypoxemia; (2 the absence of normally filtering capillary bed allows thromboembolic material to reach the systemic circulation (paradoxical embolism), which can result in transient ischemic attack, stroke or in brain abscess; (3 rarely rupture of the thin-walled PAVMs which can lead to hemoptysis or hemothorax, particularly during pregnancy.
PAVM may occur sporadically but most often in association with HHT. About 90% of patients with PAVM have underlying HHT. Screening for PAVM in patients with HHT is recommended, and patients with PAVM should be screened for HHT.
The generally accepted treatment strategy of first choice is embolization of the afferent arteries to the PAVM. It is a minimally invasive procedure and at the same time a lung preserving treatment with a very high technical success, high effectiveness and low morbidity and mortality. Embolization is a well-established method of treating PAVM, which prevents cerebral stroke and abscess as well as pulmonary hemorrhage and further raises the functional level significantly. Vascular plugs, coils or in combination are the primary choices as embolization materials.
Prof. Dr. Poul Erik Andersen
Guest Editor
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Keywords
- pulmonary artery
- pulmonary circulation
- pulmonary arteriovenous malformations
- hereditary hemorrhagic telangiectasia
- embolization, therapeutic
- radiology
- interventional
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